Company Driver or Owner-Operator

Previous Address

Do you have experience working for a U.S. DOT regulated carrier during the last 3 years?

Yes

No

Have you been subject to Drug & Alcohol testing under the requirements of the U.S. DOT F.M.C.S.A. as required by 49 CFR part 40 in the last 3 years?

Yes

No

Have you worked for Jade Transport Ltd. before?

Yes

No

Are you currently employed?

Yes

No

Employment History

(List three from most recent)

Education, Training, Qualifications & Experience

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Driver Licenses

Accident Review

Have you ever been denied a license, permit or privilege to operate a motor vehicle?

Yes

No

Has any license, permit or privilege ever been suspended or revoked?

Yes

No

Driving Experience

I certify that this application has been completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. I authorize Jade Transport Ltd. to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information provided in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all the rules and regulations of the company.